Dayton, Ohio, is one of the worst hit states by the opioid epidemic, but it’s also a town fighting to save lives with everything it’s got, and it sounds like the town has a plan that other cities and states can learn from. A November article in The New York Times (This City’s Overdose Deaths Have Plunged. Can Others Learn From It?) states that “it may be at the leading edge of a waning phase of an epidemic that has killed hundreds of thousands…in the U.S., including nearly 50,000 last year.” But now, deaths from overdoses are down more than 50% from last year.

This seems to be one of the few hopeful articles about the opioid problem, saying that all opioid deaths are decreasing, according to the CDC. Here’s how this town is doing it.

First, the governor’s decision to expand Medicaid three years ago means that more people are able to receive free addiction and mental health treatment (and more than 12 treatment centers have opened as a result. Let’s hope they’re good.)

Second, there is greater support available in the town after treatment, including tons of recovery support groups and the availability of (and training for) peer support personnel. In addition, teams comprised of social workers, police officers, medical personnel, and those in recovery visit people who have recently overdosed to try and persuade them to enter treatment.

Third, Dayton has blanketed the city with Naloxone. The police chief is adamant that his staff carry it, unlike some of his peers in other cities who view administering Narcan as enabling. He sees it as a harm reduction tool that will help him achieve his goal of saving as many lives as possible.

Fourth, Carfentanil (similar to fentanyl, a synthetic opioid 10,000 times more powerful than morphine) is not being found as frequently in overdoses. A DEA agent theorized that perhaps “traffickers realized how much of its base it was killing.”

Fifth, the police and medical workers agree with each other on an approach and are working together. The police often believe in “a punitive, abstinence-only approach to addiction,” while the medical community wants to eliminate deaths by any means possible. In Dayton, the chief supported a syringe exchange program (which was dropped in Santa Ana, ironically), and got a federal grant to distribute fentanyl test strips to check for fentanyl similarities in other medications.

You wonder: Would these steps work in cities the size of Philadelphia or San Francisco? And/or, there are enough smaller towns with a similar problem — couldn’t some of these steps be tried there?

A recent study shows what can happen when medical professionals don’t take every opportunity to help. These professional can be another part of the solution, at least when people start on opioids for pain relief and then become addicted. Researchers at the Washington State University College of Nursing studied a group of ten who fit this profile to answer two questions: How do people with chronic pain move from appropriate use of opioids to addiction? And what prompts them to seek drug addiction treatment?

Part of the reason for the study was that not many people had looked into these questions. It’s not a large study, but all of those involved fell prey to cravings and then found they were dependent on the pills.

Many of the study participants said their medical professionals could have helped them identify their addiction and get into treatment but instead they felt the providers seem to judge them, didn’t believe them when they complained, or didn’t take their pain complaints seriously. The researchers said the patients’ “most challenging relationships” were with the healthcare workers they dealt with, and what’s needed is more compassionate, nonjudgmental care.

It would be helpful if this study could hit as wide an audience as possible.

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